A family doctor in the Toronto area says she feels like she is “drowning” with the seemingly insurmountable piles of paperwork she has to complete for her patients.
Family physician and GP anesthetist Dr. Nadia Alam, who has been practising for about 15 years, made the comment during an interview with CTV News this week.
Her comments came ahead of the release of a new survey from the Ontario College of Family Physicians, which warned that one in four people in the province could be without a family doctor by 2026 due to a “worsening crisis” that has many overburdened medical professions considering leaving the field or scaling back their hours.
“The funding, or the underfunding, of family medicine, the administrative burden, the lack of resources to help me do a proper job taking care of my patients – that is what is beginning to drag me down, and I’m not alone,” Alam told CTV News in an interview Tuesday. “Over the past year, I began thinking, ‘Maybe family medicine isn’t for me anymore.’ Not because I don’t love the medicine – I actually do – it’s all that other stuff.”
While Alam still finds joy in spending one-on-one time with her 600 patients during her clinic hours, she said that she feels “dismayed” as soon as they leave – leaving her behind with a mountain of paperwork that she needs to complete on her own.
“It’s tearing me apart. I had thought of myself as a family doc, through and through, as one who would practice right up until retirement,” Alam said, teary-eyed. “To leave family medicine because of paperwork and because of a lack of resources, feels very much like I’m abandoning my patients … (My patients) bring my so much joy, and even through the heartache, I love being their doctor.”
The Ontario College of Family Physicians (OCFP) revealed in its survey that the province could see a mass exodus of family doctors leaving their clinics – or reducing their hours – with about 65 per cent planning to do so within in the next five years. In the survey, 94 per cent of family physicians said they “overwhelmed” by the administrative work as it can take up to 40 per cent of their time each week.
It is a finding that doesn’t come as a big surprise to doctors like Alam, who woke up a few hours earlier on Tuesday to try to catch up on some of her administrative responsibilities.
“I’m so behind, I know things are slipping through the cracks, and that’s actually really hard for me to admit. I got up, started working, it took me half-an-hour to do one form. I clicked on a result, had to deal with it right away, had to fill out form, after form, to – not just to figure out what I need to do with the patient – but what’s happened to the patient,” Alam said, adding she was filling out these forms to get one of her patient’s disability insurance that would permit her return to work.
“How ridiculous is that? She wants to go back to work. She’s ready to go back to work, but I have to fill out a fairly extensive form saying that she is ready to go back to work – a fact that both she and I and her supervisor, as well as the insurance company, already knows.”
ONE IN FOUR ONTARIANS COULD BE WITHOUT A DOCTOR BY 2026
On Wednesday, the OCFP said the Doug Ford government needs to urgently act as it forecasts one in every four Ontarians will be without a family doctor in just three years. This means about 4.4 million Ontarians could be without a family physician by then.
The college says this new data reflects a “worsening crisis” in the province, as in 2022 it forecasted one in five Ontarians would be without a family doctor by 2026.
Data, collected by INSPIRE-Primary Health Care earlier this year, found more than 2.2 million Ontarians are already without a family physician. In Toronto alone, 415,000 people – or just over 14 per cent of the city’s population – are lacking continued care from a family doctor.
Alam is part of the Ontario Union of Family Physicians (OUFP), a group of more than 1,000 family doctors calling on the province to stop defunding their practice so patients can receive proper care.
In September, they penned a petition pleading with the province to provide fair compensation and implement measures to attract graduates toward primary care practice. The petition has over 22,700 signatures at the time of this article’s publication.
“Family medicine is a business model that is failing, and it’s not just because of underfunding,” Alam said, quoting Dr. Ramsey Hijazi who is an organizer of OUFP. “He said, ‘We actually have enough family doctors graduating in Ontario,’ and we do, statistics show that we are graduating more family physicians than ever before. The problem is, they’re not choosing to work in family medicine.”
The Ontario College of Family Physicians on Wednesday called on the provincial government to address the issue, including introducing simple measures so family doctors can instead spend the 19 hours a week spent on administrative tasks to care for their patients.
“It’s such a waste of my time, and it’s such a waste of time for all family physicians,” Alam said.
The toll of the excess administrative responsibilities has Alam feeling she cannot continue with her practice for much longer.
“A lot of family doctors have left family medicine without being able to find anyone to take over and their patients struggle for care. Again, feels like a betrayal, feels very much like I’m abandoning them even though I feel like I’m drowning all the time,” Alam said.
“I’ve got maybe three months left in me, maybe. I’m hoping if I can get a locum to keep going, it’s got to get better. It cannot get any worse than this.”
